Permit CITY OF TIGARD SITE WORK
o A\ DEVELOPMENT SERVICES PERMIT
i i V I'I PERMIT # • SIT98 -0014
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171
DATE ISSUED: 05/06/98
PARCEL: 2S115BA -00700
SITE ADDRESS...: 16165 SW PACIFIC HWY
SUBDIVISION • ZONING:
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK..: ALT PAVING? N RESO. NO.:
TYPE OF USE •SFA : GRADING? Y VALUE...$: 1500
EXCV VOLUME: 0 cy LANDSCAPING? • N
FILL VOLUME: 1000 cy SITE PREP? • N
ENG FILL? • N STORM DRAINS ?...: N
SOILS RPT READ ?: N IMPERV SURFACE: 0 sf
Re marks : Place 1' cu. yd. of fill on a legal lot.
Owner: FEES
H E RANDALL type amount by date recpt
16165 SW PACIFIC HWY PRMT $ 25.00 DEB 05/06/98 98- 305521
KING CITY OR 97224 5PCT $ 1.25 DEB 05/06/98 98- 305521
PLCK $ 16.25 DEB 05/06/98 98- 305521
Phone #: 684 -8234 FIRE $ 10.00 DEB 05/06/98 98- 305521
Contract or:
SUPER ONE INC
10950 SW 5TH
STE 150
BEAVERTON OR 97005
Phone #: 643 -5721 $ 52.50 TOTAL
Reg #..: 000571
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 1:', days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -001 -0010 through OAR 952 - 001-0080. Your may
obtain copies of these rules or direct questions to DUNE by calling
(503)246 -9187.
Issue by: P ermittee Signature: . ��_i ,,w
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
II 1.20,0 .70,4
Recd By CITY OF TIGARD Site Permit Application
Date Rec'd 44 8-
13125 SW HALL BLVD. Commercial: Complete ENTIRE form Date to P.E.
TIGARD, OR 97223 Residence: Complete SHADED areas . to DST . " , E' ', ` ; y:;;
(503) 639 -4171 x304
'CC/ #,�tt •, - °0J 9
D ,►/ n L p Related SWR #
�/ Called
Print or Type 4 /vC )*- i'
Incomplete or illegible applications will not be accepted
Project Name Utilities (Complete all that apply)
Job
Address Address . 7.." - - - , - Storm Sewer
161 ' J a /1 c
r� * �' Linear Ft.
- Nau -- t - � 1 // (' / Sanitary Sewer
t .Ql�d // / V c3-7 Linear Ft.
Owner ddress _ - Fresh Water
S E., - - . Linear Ft.
C' /State 9 Phone - Catch Basins
General Name C//
Clean Outs
Contractor „S /)p— y j –,477, _ #
NCO to it Mailing A dress Describe work to be done:
copy of all /6 9)0 kreti, � s Newp Addition❑ Alteration!: RepairD
Il enses are ty /State s, LI Z. Ph one Additional Description of Work: - -
required it Jfav f r/c� n / )�o ` ` y3" ( f72 /
expired in COT St 0 o s Cont. o Board Lic. # E c p. Date q Q - - . V J N6? ; ' + t� e '' ' - •
database 3 / Q
Name f ! Project >
Valuation $ 4 / , 6
Architect Mailing Address Plans Required: See Matrix on back__ _ . .
The following, must accompany this application: •
City /State Zip Phone Site plan with Vicinity Map Parking (including
�./- Showing ADA compliance ADA) &Lighting Plan
t — Grading Plan and details Landscaping Plan
Name
747—
u ew
Engineer Mailing Address > / Erosion Control Plan and - Retaining Structures
FG:3G / f d`A ?i& f details • • including calculations
City /State Zip Phone Site Utility Plan and details Soils Report -
P ?, / /_ , x/4 n r (showing connection to approved system) (if requin:d)
�! T a
Excavation Volume I hereby acknowledge that I have read this application, that the
(Soils report required for >5,000 cu. Yards information given is correct, that I am the owner or authorized
P' / - • cu. yds. agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Fill Volume Signature of Owner /Agent _ Date
(Soils report required for >5,000 cu. Yds.) ± ` - _ _ _
cu. yds. - - - -
Will the fill support a structure Contact Person Name ' Phone
(Engineer required if answer is yes) YESO KA _. =
Retaining structure? (check one) DRock FOR OFFICE USE ONLY ,
D CMU Notes:
❑Concrete
pother
Total new impervious area including all Land Use Case # Map/TL#
buildings, sidewalks, and paving Sq. Ft. a5/ /5
siteapp.doc 3/98
At •
COMMERCIAL PLAN SUBMITTAL
•
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 -- -- 3 (j,o,u) -- --
B (New or Add) 1 1 -- -- 3 (j,o,w) -- --
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- --
B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- --
P (New, Add. or Alt) 2 -- 2 -- -- 20,0) -- .
B & M & P.. (New or Add.) 2 1 1 -- 3 (j,o,w) 20,0) --
B (New, Add, or Alt) ' _ . 2 -- -- 2 -- -- 2(j,o)
B & M & P E (New, Add) 3 1 1 1 3 (j,o,w) 20,0) 2 (j,o)
::off::''
alt
.....: >:
. � :..
.. ., . .
. . .. .. .::::: i :: :...:: . .... .. ....... .........::::: : . .. . :. ..... .':. .:: :::: :v :. : . : :. i ... .: . ::: :. ... ww:. :... .' i. ?v. 'i::: ::''l:::�:
::::B '::..:::.
. �M. - :. •: '. ': iii:: i:: i �: ':: is:ii::i.ii::i::::::: {:i:: >:: ::: { :i:. :: S�:i: Si:: :'l,.:i:: : }:S :i::::i:: ::::i:: : n : i .i:: ': :}i . i: : {:: is � :. ::: �: ' <i { :i : ' ::i: r:: is : :.i. ... : � i::::S:i
..........: &nP& E. " Eft: �._::.:.:::..........:.. 3:.:.. I.. ....:.?.:... > : : ::: : : , .:�: ::.:. ::: :..:: . . . ... ... . .: :::
•
NOTES: KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = MEC
updates and adds actions.._. f = Fire P = PLM
u =USA E =ELC
: >>S = —
.....»> �;:: v:;:;;�:. �. ;':::. F:. �..,. �.: ::::::..:..:: ?�:.:.:.:>:.:.;:.:;:.>;::. i; :::. >;.;�.;�.;�.i;;;:.;:. >:':: as County F —FPS
c. FPS is a new permit category aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
h:Umatrie.Doc
siteapp.doc 3/98
OVER - THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL ( S • • _.• 111 :,,e.. , ....-- - - ----,- -- - ' - S .
y
DESCRIPTION OF PROJECT: t TIZ t 0 E, D A P ie.go gAtr74.
USA W 11-,, z A)S p tiT' Gre.A DrA.)4 S e4ecien)
N -j'201_, -- /4 FiAoc.. 'S_,J az % 747i
WIt.LbG_ Qt?�-
CLASS OF WORK: FLOOR AREAS: EXTERIOR WALL CONSTRUCTION
TYPE OF USE: FIRST SQ. FT. N: S: E: W:
TYPE OF
CONSTR: SECOND SQ. FT. PROTECT OPENINGS ?:
OCCUPANCY GRP: THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: TOTAL SQ. FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: i BSMNT: SQ. FT. i AREA SEP. RATED:
I 1
BSMNT ?: MEZZ ?: i GARAGE: SQ. FT. i OCCU.SEP.RATED:
1 1
FIRE FIRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS:
I COMMERCIAL INSPECTION ACTIONS FEE MENU\
Foot/Found Post/Beam $ a- " Permit Fee -
Masonry Framing $ 'G Plan Review
Insulation Shear Wall $ / •A' . 5% State Surcharge
Firewall Gyp Board $ /6 FLS Plan Review
Suspended Ceiling Sprinkler Rough -in $ Add'I Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pin
Smoke Detector Approach /Sidewalk $ Inspection
Miscellaneous - _ $ MIS Fee E12.4
CDC'
FOR OFFICE USE ONLY:
TYPE OS USE OPTIONS (COM= commercial; CMS = commercial manufactured struct� il re - '
CLASS OF WORK OPTIONS FOR ALL PERMITS (NEW =new; Add = addition; ALT = alteration; ACS = accessory ;FND - foundation;
OTR= other; DEM= demolition; REP = repair; FPS =fire protection system, NOTE: USE OTR FOR FENCES, RETAINING
WALLS, DETACHED DECKS, SIGNS, AWNINGS, CANOPIES)
I: \ovrcntr2.doc (DST) 4/97
•
7/26/99 Activities for Case. #: SIT98 -00014
8:48:27 PM .
Assigned • Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SITA005 Application received 5/4/98 RP RECD GEO 5/5/98
SITA008 Permit Created 5/5/98 GEO DONE - • GEO 5/5/98
SITA799 Phial Inspection 5/5/98 1/19/99 GS PASS GES 1/19/99 1/8/99 inspection request
• • (research) sent to Hap THIS
• PERMIT WAS PART OF THE
• BEST WESTERN MOTEL AT
16105 PAC HWY. ALL FILL .
AND GRADING REPORTS
FOR THAT SITE ALSO
• APPLIES TO THIS ONE. GS.
SITA080 (F) Ready to issue • 5/5/98 GEO PASS GEO . 5/5/98
SITA092 (F) Issue permit 5/6/98 DEB DONE DST 5/6/98
SITA800 Case Finaled 1/19/99 JT 1/19/99
•
•
•
•
•
Page 1 of 1
•
.
• H 1 e
,
• / 6 irrai-0 14
I Ke•,4 - .,.
.,0,,,; .F.ING..,.., _
. ,
........................ , ...,,„ ciA
*.i.... II
"41'=-1z-t... ftkr-e A
• -.,
.
. 1 - '
•
/ . . . t ...
-. - .. ,,,. . . .....• . a .....• ••■• . • ■.••■•••■ '''''''.."""................"'''....
. f''' •
1 4.36 mi
to
' •
f 1 500
i ! •
r . .... . .. _-.--
1 1 - 1 S ECTI IICTI C O N N I : - - - - - : - ‘ ' Z ' . . -/. C----'
1 / 1ST 044i411 .."'•
I 'US l
, •
-
/ g SC, 23 ...7
)K V 41- FAT 1 K1 ea, & 1 g ..,
, - ;,.
601 ••
tovi•-- vn
ST m .•• art
1 . I • 5 t
1 . Air/
)
; .I• • VC
• I 600
o 2
si. COONS* ;s4 r ei „Lai
LOT 11, *Lout s ----' - S-XlsT II) 0 • sirs art me h7.11 1144 1.454e. n #
... lk ■
irk Alwate•
. I 611-1
• 44.41114111 • -§ •371 1 \1V .... C
ma.. 4r iN A
1 b\ ! ( C 0.1 ! t. E. 1.1 F:a '''•• , g /
7 SSA/ F, 8 ._. 1 1 se S e u.) SK v...-% .
• co'mg. i An ,
IXIT re St= S .-- uSiumluato ‘-' \ ..d
me Cm too., 1:1.13.4e. .
• p.6.-'..• . 6'0' «i P
A .... 4 ..: • ' ';' '10:4 - _fee - N. _-
t , 9 91°N r . C \PI 4v\ia,s.6e , - •-•"' k \ 44.9,- i lei E Ase A.4 t:40 • r i t .14:e4To ' j//.
coc‘d\\•\° 0046 . .------ . ,...-•-..-":'-' ,..,,...". . iir- • / "ro - c. &ave. - ;. 4 to RAp.IT
o i - 0 01 1 \AO. .-- \\041:,':"....„--,'"Ii‘ -----* • , .
7 00 I t.., .. - - • 1,fc - , - .-
1? C04.4t p,k \ $0 v eNe • - - I va- X I 4°. li`i . ' _ _EP . 4 P /
, •
•0 6(-e55.. _....- ---. • 3.75 It.) i F 0 i rA clE. ma . - g -- -
•
vit) • --- t 0A 0 ,
I.; .
e,
-. ....
,
AT a g_ • /
. -...,,
, ., , ,•EN •
..
4 (fi-,.'" •
SEE MAP • Y%
-c (4 •
2S I 10 C 0 ,c3. / .g-g i - ri.
(,.... Iwo: 74.4 t) v• / ro ---
n
I e R. , ,//
• / •
444.46 •
. 114•14044‘ VTR u
SEE MAP I
nowt a -. 1200:
2 S 1 1588 f . .
. . * • - 46 ! • • •
GSM NSOI 0
4. . t.
. . LEI.* L C.
43. _. ;- 1300 - • /
I 000
46- •
00 I I , • ( • 1
2, 9.
ss..14 . • rIci-i ot.11_,,/ ; • 4 .
K ri 1\14
7 i . . , •
,
500
41 .
,
• ••• , swab • i • ''..- 1.
SOO I '
1 • .
. • . • -
• :._ 48
s
i4.00 I . f
,. 414:48 e
• ,.._ .- .
-
• I /